Spear Rafaëlle, Clough Rachel E, Fabre Dominique, Roeder Blayne, Hertault Adrien, Martin Gonzalez Teresa, Azzaoui Richard, Sobocinski Jonathan, Haulon Stéphan
1 Aortic Center, Hôpital Cardiologique, CHRU Lille, France.
2 CardioVascular and Thoracic Surgery, Marie Lannelongue, Plessis-Robinson, France.
J Endovasc Ther. 2017 Aug;24(4):534-538. doi: 10.1177/1526602817714569. Epub 2017 Jun 12.
To report early experience with a new endovascular graft developed for aortic arch aneurysm repair in patients unfit for open surgery.
Three consecutive men (62, 74, and 69 years old) at high risk for open repair were treated for postdissection aortic arch aneurysms using a custom-made 3 inner branched endovascular graft. The 2 proximal branches are antegrade and perfuse the innominate artery and the left common carotid artery; the third branch is retrograde and perfuses the left subclavian artery. The latter is preloaded with a catheter and wire to aid cannulation. Technical success was achieved in each case. The mean procedure time, fluoroscopy duration, and contrast volume were 180 minutes, 35 minutes, and 145 mL, respectively. The perioperative period was uneventful. All branches were patent on 6-month computed tomography and duplex ultrasound imaging.
This new patient-specific device allows total endovascular revascularization of the supra-aortic trunks during arch repair. These encouraging results support its more widespread use.
报告一种为不适于接受开放手术的患者进行主动脉弓动脉瘤修复而研发的新型血管内移植物的早期应用经验。
连续3名男性患者（年龄分别为62岁、74岁和69岁），因接受开放修复手术风险高，采用定制的三分支血管内移植物治疗主动脉弓夹层动脉瘤。2个近端分支为顺行，灌注无名动脉和左颈总动脉；第3个分支为逆行，灌注左锁骨下动脉。后者预先置入导管和导丝以辅助插管。每例手术均获技术成功。平均手术时间、透视时间和造影剂用量分别为180分钟、35分钟和145毫升。围手术期无并发症。术后6个月的计算机断层扫描和双功超声成像显示所有分支均通畅。
这种新型的个体化装置可在主动脉弓修复过程中实现主动脉弓上血管的完全腔内血运重建。这些令人鼓舞的结果支持其更广泛的应用。
